Utilization Review Coordinator jobs in Detroit, MI

Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

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Utilization review coordinator
  • Theramatrix Physical Therapy Network, Inc
  • Pontiac, MI FULL_TIME
  • Job Description

    Duties and Responsibilities :

    Initial authorizations of outpatient physical therapy services : Reviews and authorizes services that meet criteria, along with supporting documentation.

    It is the responsibility of the URC to ensure outpatient physical therapy services are provided at the appropriate level and are received per the defined plan guidelines.

    • Re-authorization / concurrent review for continued therapy : Reviews clinic documentation submitted by the provider to ensure services continue to meet defined plan guidelines.

    Will facilitate all Care Management related communications being sent to the member.

    Additional responsibilities include :

    • Investigate and resolve questions related to authorization and claims activity.
    • Assists in maintaining department compliance with state, federal, HIPAA and DOL regulations.
    • Assists in resolving issues relative to clinical procedures.
    • Participates in monthly Health Services Meetings.
    • Potential for limited local travel to attend Client Health Fairs.

    Qualifications and Experience :

    Individual must be results and goal oriented. Must be self-directed and can communicate effectively, both orally and in writing.

    Computer experience required : Word, Excel, Internet.

    • Two to five years of experience, preferably in a managed care environment
    • Working knowledge of the physical therapy industry is a definite plus.
    • Strong written and verbal communication skills.
    • Strong customer service skills / experience.
    • Strong computer skills a must (Word, Excel, etc.).
    • Independent, self-starter who is results and goal oriented.

    Education :

    Healthcare professional with an acquired background in physical therapy. Must possess an Associate's Degree, Bachelor’s degree preferred.

    Experience in lieu of a degree will be considered.

    Company Description

    Exceptional Customer Service starts with having team members who understand and embody collaboration and team work. It continues every day with a positive, problem-solving approach to any issues or concerns - regardless of how small and with continued expression of appreciation for our team.

    What we do is so important. Interested in joining us in that mission?

    Exceptional Customer Service starts with having team members who understand and embody collaboration and team work. It continues every day with a positive, problem-solving approach to any issues or concerns - regardless of how small and with continued expression of appreciation for our team.

    What we do is so important. Interested in joining us in that mission?

    Last updated : 2024-03-23

  • 2 Days Ago

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Discharge Planner - Utilization Review
  • Garden City Hospital
  • Garden, MI FULL_TIME
  • Overview: Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden City Hospital, a member of Prime Healthcare, offers incredible...
  • 19 Days Ago

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Utilization Review Manager - PRN
  • Harbor Oaks Hospital
  • New Baltimore, MI OTHER
  • Overview Harbor Oaks Hospital is looking for a PRN - Utilization Review Manager to join our team! Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking ...
  • 20 Days Ago

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Utilization Review Nurse
  • LanceSoft Inc
  • Detroit, MI FULL_TIME,CONTRACTOR
  • Job Description: This position will be remote role for Nurses in Michigan Should have a valid MI RN License Should Have utilization management experience. Should have experience completing post-acute ...
  • Just Posted

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Utilization Review Specialist
  • StoneCrest Center
  • Detroit, MI FULL_TIME
  • Act as liaison between managed care organizations and the facility's professional clinical staff. Conduct interviews, in accordance with certification requirements, of insurance plans or other managed...
  • 7 Days Ago

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RN Utilization Review FT Days
  • Detroit Medical Center Shared Services
  • Detroit, MI FULL_TIME
  • The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan and beyond. A premier healthcare resource, our mission is to help p...
  • 3 Days Ago

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0 Utilization Review Coordinator jobs found in Detroit, MI area

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Accreditation Coordinator - Medical Education
  • Henry Ford Health System
  • Detroit, MI
  • The Accreditation Coordinator for Medical Education is an essential part of the continued compliance and accreditation f...
  • 3/28/2024 12:00:00 AM

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Utilization Review Coordinator
  • TheraMatrix
  • Pontiac, MI
  • Job Description Job Description Duties and Responsibilities: Initial authorizations of outpatient physical therapy servi...
  • 3/28/2024 12:00:00 AM

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Public Safety Dispatcher - Full Time
  • City of Bloomfield Hills
  • Bloomfield Hills, MI
  • The City of Bloomfield Hills, Michigan, is seeking qualified individuals interested in a position as a Public Safety Com...
  • 3/28/2024 12:00:00 AM

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Team Lead, Field Operations
  • AES Corporation
  • Detroit, MI
  • At AES, we raise the quality of life around the world by changing the way energy works. Everyone makes an impact every d...
  • 3/27/2024 12:00:00 AM

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Medical Device National Service Manager - Ventilation
  • Vyaire Medical
  • Detroit, MI
  • Medical Device National Service Manager - Ventilation Help the World Breathe Easier by Collaborating with Innovative Vya...
  • 3/25/2024 12:00:00 AM

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Administrative Coordinator
  • G-TECH Services
  • Livonia, MI
  • Job Description Job Description Administrative assistant performs all general office duties- such as receptionist, set u...
  • 3/25/2024 12:00:00 AM

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Administrative Assistant
  • Presbyterian Villages of Michigan
  • Detroit, MI
  • Overview: Provides office services by implementing administrative systems, procedures, and policies, and monitoring admi...
  • 3/24/2024 12:00:00 AM

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Staff Project Engineer - Program Management (Great Lakes Region)
  • Burns & McDonnell
  • Detroit, MI
  • Description Our Transmission & Distribution Global Practice is looking for a Project Engineer to support our Great Lakes...
  • 3/24/2024 12:00:00 AM

Detroit (/dɪˈtrɔɪt/, locally also /ˈdiːtrɔɪt/; French: Détroit, lit. 'strait') is the largest and most populous city in the U.S. state of Michigan, the largest United States city on the United States–Canada border, and the seat of Wayne County. The municipality of Detroit had a 2017 estimated population of 673,104, making it the 23rd-most populous city in the United States. The metropolitan area, known as Metro Detroit, is home to 4.3 million people, making it the second-largest in the Midwest after the Chicago metropolitan area. Regarded as a major cultural center, Detroit is known for its co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$81,565 to $101,031
Detroit, Michigan area prices
were up 1.2% from a year ago

Utilization Review Coordinator in Fort Lauderdale, FL
Some review coordinator positions require that professionals have training and experience within a more specific field.
January 10, 2020
Utilization Review Coordinator in Asheville, NC
Schick Shadel Hospital is seeking a part-time (20 hours per week) Utilization Review Coordinator (UR Coordinator) to help oversee and perform the process of utilization review to ensure appropriate reimbursement by third party payers.
January 04, 2020
Utilization Review Coordinator in Jacksonville, FL
Excellent benefits, pay, small on-site employee gym, wonderful co-workers and managersFull Review.
January 04, 2020